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#TIPS_&_Tricks for ostial RCA disease with tortuous vessel NSTEMI scenario here .. What happened ?? #TROUBLESHOOTING - AVOID AMPLATZ guides - Airmailing technique to be used with a soft torquable wire & preferably with trackable microcatheter - DO NOT INJECT when this has happened, if u have to use... show more

Abad khan,MD/DM

2,239 subscribers

11,916 views • 1 year ago •via X (Twitter)

#TIPS_#TROUBLESHOOTING

Anya Rossi• Live Now

Private livecam show

10 Comments

Dr . $@ndeep K@m@t1 year ago

I would shift to femoral and I prefer doing something called "Amplazting" of a JR guide catheter(looping the JR guide) like this in such scenarios..always works fr me especially when the RCA ostium is nasty.

Abad khan,MD/DM1 year ago

But AMPLATZING of JR will cause the same issue and runs the same risk of ostial Dissection of a dominant RCA ..

Joy Sanyal,MD, DM,1 year ago

Probably a XB RCA or a 7F JR with GEC- usually I always do it with XB RCA instead of AL it has shorter curve

Abad khan,MD/DM1 year ago

Great options .. But GEC ? For dominant RCA's and Ostial and proximal diseases is it the best option to use GEC to reach distal RCA if hardware doesn't track in a tortuous anatomy ?

SREEVATSA NADIG DM FSCAI FESC1 year ago

Ostial RCA dissected and vessel closed

Abad khan,MD/DM1 year ago

No no no .. There is a very peculiar thing happening which was stored on this florosave loop which almost RULES OUT DISSECTION WITH ABRUPT VESSEL CLOSURE ..

Sudeep K N1 year ago

Suspicious prox dissection while pulling back diagnostic catheter .can see dye stasis in upper portion of RCA..... interesting to know how case was managed.

Abad khan,MD/DM1 year ago

No dissection .. but u risk one when such thing has happened and u give dye injection

hitesh1 year ago

Amplatz confirmed the ostial disease

Qasim Raza, 𝘔𝘋1 year ago

It's like Carabellos sign but for coronaries 😄 for those curious:

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After 2.5-3 hours, I’m ready to stretch my legs and use the restroom. Honestly, it’s better for you to do this anyway. You ONLY need to charge ENOUGH to get to the NEXT STOP. That’s the whole point of Supercharging. This is a very simple concept that somehow people have forgotten. Everyone knows it’s not the speed you charge, it’s your price per kWh that determines the cost. In this scenario, I only needed enough to get home. If I had a BYD and flash charged for 9 minutes, I would have spent the same amount of time and more money. I got home with 14% and am now charging for $0.04 per kWh. So how would flash charging have helped me here? It wouldn’t have, literally at all. Because both of us needed to go in to use the restroom and get a snack, which took about 9 minutes! Not saying charging can’t be improved, but it’s not an inconvenience 99% of the time with what we have now.

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177,578 views • 1 year ago

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WHAT A TRAGEDY! I can’t believe this happened to these beautiful little girls. A future has been cut off in such a painful manner that is so difficult to come to terms with. May God keep their innocent souls in perfect peace. My prayers are with the bereaved families. May the joy of the Lord strengthen you to enable you go through this difficult phase of your life. THE LOST OF ANY CHILD ANYWHERE IS THE LOST OF A FUTURE EVERYWHERE. Can a mother leave her children? Certainly not! But the painful thing here is that, as the mother cannot leave her children, in this regrettable condition, the children have left their mothers. As a mother, I can deeply relate with the mothers of these kids and what they may be going through by now. It is too painful to remember and too painful to forgive. At this moment all I wish to say is that, I pray for grace to be sufficient for you in this condition. I pray for strength for the both families of the kids. I pray for healing of hurts for all involved in this painful tragedy. I pray for love and empathy for the victims and sympathy for all who may need it. With a very heart I say PLEASE HAVE MY CONDOLENCES… GOD WILL TAKE CARE OF YOU!!!

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27,268 views • 1 year ago

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Overton

651,427 views • 5 months ago

VIDEO | Delhi: Congress leader Manish Tewari on prominent citizens from India and Pakistan appealing PMs of both countries for 'restoring peace, normalcy, dialogue', says, "Well, that's not an appeal for a dialogue. It is an instrument of an unconditional surrender. We want peace with Pakistan, but it has to be peace without terror. It has to be peace with honour. Has Pakistan given any commitment that it will dismantle the entire military jihadi complex. That they have very assiduously nurtured since the late 1970s. Has Pakistan said that they would ensure that the soil of their country is not used for perpetrating terror against India. A commitment which was given by President Musharraf in 2002 in a televised address to the people of Pakistan, as well as reiterated when Prime Minister Atal Bihari Vajpayee visited Islamabad in December 2004 for the SAARC Summit. And then repeated ad nauseam in the conversations that took place with between Dr. Manmohan Singh and his Pakistani interlocutors, or even Prime Minister Modi later with his Pakistani interlocutors. So, therefore, the question is not peace. The question is, peace at what cost? Peace cannot come with a gun to your head, you know, with somebody holding the gun of terror to your head. And all these people who've written this letter are very eminent people in their professional and private capacities. They have dealt with the Pakistanis over the entire span of their professional careers. They exactly know as to how perfidious these people are as to how they say one thing and mean the other thing altogether. And therefore, if there has to be peace, or if there has to be a dialogue, terror and talks cannot go hand in hand. You need to ensure that Pakistan dismantles the entire infrastructure of terror that Pakistan have created. Who does not want peace? Everybody wants peace, but it has to be peace without terror and peace with honor." (Full video available on PTI Videos -

VIDEO | Delhi: Congress leader Manish Tewari on prominent citizens from India and Pakistan appealing PMs of both countries for 'restoring peace, normalcy, dialogue', says, "Well, that's not an appeal for a dialogue. It is an instrument of an unconditional surrender. We want peace with Pakistan, but it has to be peace without terror. It has to be peace with honour. Has Pakistan given any commitment that it will dismantle the entire military jihadi complex. That they have very assiduously nurtured since the late 1970s. Has Pakistan said that they would ensure that the soil of their country is not used for perpetrating terror against India. A commitment which was given by President Musharraf in 2002 in a televised address to the people of Pakistan, as well as reiterated when Prime Minister Atal Bihari Vajpayee visited Islamabad in December 2004 for the SAARC Summit. And then repeated ad nauseam in the conversations that took place with between Dr. Manmohan Singh and his Pakistani interlocutors, or even Prime Minister Modi later with his Pakistani interlocutors. So, therefore, the question is not peace. The question is, peace at what cost? Peace cannot come with a gun to your head, you know, with somebody holding the gun of terror to your head. And all these people who've written this letter are very eminent people in their professional and private capacities. They have dealt with the Pakistanis over the entire span of their professional careers. They exactly know as to how perfidious these people are as to how they say one thing and mean the other thing altogether. And therefore, if there has to be peace, or if there has to be a dialogue, terror and talks cannot go hand in hand. You need to ensure that Pakistan dismantles the entire infrastructure of terror that Pakistan have created. Who does not want peace? Everybody wants peace, but it has to be peace without terror and peace with honor." (Full video available on PTI Videos -

Press Trust of India

59,074 views • 1 month ago

#WATCH | Bengaluru | NEET-UG re-examination | KPCC President BK Hariprasad says, "...The Education Minister has not resigned. UPSC papers have leaked, and CBSE exam papers have also leaked. Students who were supposed to be stopped could not reach the exam centres, but they still wrote the exams. They themselves say they wrote the exams, but they have spoken against the hardship they faced in reaching the exam centre. Unfortunately, if anything like this has happened, it should not have happened. We had taken all precautions because we had a programme on Sunday to avoid any traffic hassles. We had discussed with the police and with our Congress colleagues. Several workers made elaborate arrangements to control traffic...For some reason, some children might not have been able to reach. I do not know the reason, but we will send a Congress team to find out what kind of hardship they faced. If there is any compensation required, we will compensate...Those who leaked the question papers should have been punished. We have taken all precautions. If we had not taken precautions, thousands of people would have faced problems. What precautions has the BJP taken? They should answer that. This is a political blame game; they are trying to cover up their own mistakes and putting the blame on us..."

#WATCH | Bengaluru | NEET-UG re-examination | KPCC President BK Hariprasad says, "...The Education Minister has not resigned. UPSC papers have leaked, and CBSE exam papers have also leaked. Students who were supposed to be stopped could not reach the exam centres, but they still wrote the exams. They themselves say they wrote the exams, but they have spoken against the hardship they faced in reaching the exam centre. Unfortunately, if anything like this has happened, it should not have happened. We had taken all precautions because we had a programme on Sunday to avoid any traffic hassles. We had discussed with the police and with our Congress colleagues. Several workers made elaborate arrangements to control traffic...For some reason, some children might not have been able to reach. I do not know the reason, but we will send a Congress team to find out what kind of hardship they faced. If there is any compensation required, we will compensate...Those who leaked the question papers should have been punished. We have taken all precautions. If we had not taken precautions, thousands of people would have faced problems. What precautions has the BJP taken? They should answer that. This is a political blame game; they are trying to cover up their own mistakes and putting the blame on us..."

ANI

28,284 views • 2 months ago

🚨 LMFAO! Elon Musk gives the most ELON answer to "what would you do if you started over with $1,000?" "It's somewhat of an impossible dichotomy, because civilization would have had to have been destroyed or something, in which case $1,000 is not going to solve your problems." "And if civilization hasn't melted, then I could probably just tell people to give me money, which I've done before." 🤣🔥 Elon Musk "A lot of things would have to go wrong for that to be the case. It's like, am I just emerging from prison, perhaps, with a stipend? All my companies have been confiscated." "I mean, it would take armageddon, which hopefully that doesn't happen, like Ragnarok next level, and I lost." "I mean, it's impossible for someone to have this amount of knowledge, all the knowledge that I have, and then be dropped down to a low resource amount." "Because the reality is that either something truly catastrophic has happened, like civilization has melted, or I will be able to ask people to just give me money, and with the promise that I will have a high return, which is what I'm able to do right now. Like if you give me a dollar, you will get back much more than a dollar."

🚨 LMFAO! Elon Musk gives the most ELON answer to "what would you do if you started over with $1,000?" "It's somewhat of an impossible dichotomy, because civilization would have had to have been destroyed or something, in which case $1,000 is not going to solve your problems." "And if civilization hasn't melted, then I could probably just tell people to give me money, which I've done before." 🤣🔥 Elon Musk "A lot of things would have to go wrong for that to be the case. It's like, am I just emerging from prison, perhaps, with a stipend? All my companies have been confiscated." "I mean, it would take armageddon, which hopefully that doesn't happen, like Ragnarok next level, and I lost." "I mean, it's impossible for someone to have this amount of knowledge, all the knowledge that I have, and then be dropped down to a low resource amount." "Because the reality is that either something truly catastrophic has happened, like civilization has melted, or I will be able to ask people to just give me money, and with the promise that I will have a high return, which is what I'm able to do right now. Like if you give me a dollar, you will get back much more than a dollar."

Eric Daugherty

8,288,751 views • 8 months ago

🚨 JUST IN: Trump is at the Kennedy Center for the board meeting and a tour. He is totally overhauling it. He says they wanted to charge Lee Greenwood $30,000 just to sing there. Trump also says he is going to get with Speaker Johnson to fix its architecture. "We're here to have our first board meeting, Kennedy Center, and it's in tremendous disrepair, as is a lot of the rest of our country, most of it because of bad management." "We have a little problem with some people that work here. We had Lee Greenwood wanted to sing a little song today. And because of the cost in the union structure, for him to sing a song just for the board, just a board meeting, that was gonna cost $30,000. That doesn't sound too good. They wanted $30,000 to move a piano. So you can't have that. So we're gonna we're gonna fix it up." "It's really emblematic of our country. At the Kennedy Center, you look at the columns outside, you look at, I mean, they're supposed to be covered by something, whether it's marble or granite. They were never covered. They were painted. But, bring it into more modern times, a lot of money has been given to it, and the money has not been properly spent." "They built rooms underground with no windows, no nothing that will not be used ever. You're not gonna have people use them. It's such a waste of money, such a terrible waste, but we'll make it we'll bring it back. We'll make it great again. But it is so much like what I'm witnessing in other places." "We have open borders. We have men playing in women's sports. It's all the same thing. It's all the same mentality and thinking. So I'm very disappointed when I look around." "The bottom line, it has tremendous potential, and we'll work with Congress. As you know, it's a very public, a very public facility, and we'll do what has to be done. We'll be having a meeting with the speaker in the not too distant future. I think it's important to save this structure in this building."

🚨 JUST IN: Trump is at the Kennedy Center for the board meeting and a tour. He is totally overhauling it. He says they wanted to charge Lee Greenwood $30,000 just to sing there. Trump also says he is going to get with Speaker Johnson to fix its architecture. "We're here to have our first board meeting, Kennedy Center, and it's in tremendous disrepair, as is a lot of the rest of our country, most of it because of bad management." "We have a little problem with some people that work here. We had Lee Greenwood wanted to sing a little song today. And because of the cost in the union structure, for him to sing a song just for the board, just a board meeting, that was gonna cost $30,000. That doesn't sound too good. They wanted $30,000 to move a piano. So you can't have that. So we're gonna we're gonna fix it up." "It's really emblematic of our country. At the Kennedy Center, you look at the columns outside, you look at, I mean, they're supposed to be covered by something, whether it's marble or granite. They were never covered. They were painted. But, bring it into more modern times, a lot of money has been given to it, and the money has not been properly spent." "They built rooms underground with no windows, no nothing that will not be used ever. You're not gonna have people use them. It's such a waste of money, such a terrible waste, but we'll make it we'll bring it back. We'll make it great again. But it is so much like what I'm witnessing in other places." "We have open borders. We have men playing in women's sports. It's all the same thing. It's all the same mentality and thinking. So I'm very disappointed when I look around." "The bottom line, it has tremendous potential, and we'll work with Congress. As you know, it's a very public, a very public facility, and we'll do what has to be done. We'll be having a meeting with the speaker in the not too distant future. I think it's important to save this structure in this building."

Eric Daugherty

423,717 views • 1 year ago

Milestone! We (robotic arms for gadgets assembly) finished the first commercial order, which brought the first revenue. Here are some learnings from this: The customer was a smart toy manufacturer. The task was to add a heatsink to Raspberry Pi. We received parts from them and returned the assembled modules back. Currently, it's done by teleoperation. Later it will be done by a remote employee via the Internet. Then it will be automated action by action, reducing the operator's time on this and making the task profitable. ps. If you have an assembly task that we can do for you asynchronically - leave a comment below. Learning 1. It's possible! This task which is usually done by the human arm with 5 fingers can be done with a two-finger gripper with the addition of a couple of simple tooling. The task was not simplified. We peeled off thin films from stickers, unpacked paper boxes, moved PCB boards full of components, etc. And no unsolvable problems have been encountered yet. Challenges: 1) The paper box shifted during the opening Solved with the plastic walls that you can lean against 2) Heat pad, stuck to the gripper instead of heat sync. Can be solved by gripper with a pump, but this time solved with the patience of the operator 3) The film on the pad is very thin. Turned out that sub-millimeter arm precision is enough to peel it off with just a regular gripper. 4) The working area has not enough space. You'll only know this by doing real tasks in bulk. This could be solved by an extra pair of long arms, but in this case, solved with the patience of the operator. I think that in the end, we will have 5-10 types of universal tooling and 5-10 types of grippers to solve almost all the problems in such assembly tasks. Learning 2. It's slow. It took 5 times more time, than doing it with human hands. But the good news is there's a lot of room for improvement. We now have specific “time for task” metrics, which we will decrease with iterations. The main reasons for slowness: 1) To rotate the gripper to a steep angle you are forced to control one robot arm with two hands instead of using both arms. We can fix this by just making more room for rotations. 2) Grabbing PCB board with two arms is hard. A slight difference in rotation can break the board, and it's hard to control these angles visually. To solve this, the best way is to use force feedback so you can feel the pressure applied to the item. 3) Accuracy and steadiness is still can be improved We will try a metal version and double the motors to do this. 4) It is physically difficult for the human hands to move with such precision To solve this, we will add a pad for the hands like in surgical robots Learning 3. It's a good business model The "Factory in the cloud" is a good business model for this stage. You send us parts and we send back assembled modules. Currently, it's more convenient than sending a robot to your place, as we can iterate/fix the robot quickly and utilize it 100% of the time. When we polish the set-up over time - we can send robots to your place. So if we can assemble something for you in the USA with Chinese prices by using modern automation - leave a comment below.

Milestone! We (robotic arms for gadgets assembly) finished the first commercial order, which brought the first revenue. Here are some learnings from this: The customer was a smart toy manufacturer. The task was to add a heatsink to Raspberry Pi. We received parts from them and returned the assembled modules back. Currently, it's done by teleoperation. Later it will be done by a remote employee via the Internet. Then it will be automated action by action, reducing the operator's time on this and making the task profitable. ps. If you have an assembly task that we can do for you asynchronically - leave a comment below. Learning 1. It's possible! This task which is usually done by the human arm with 5 fingers can be done with a two-finger gripper with the addition of a couple of simple tooling. The task was not simplified. We peeled off thin films from stickers, unpacked paper boxes, moved PCB boards full of components, etc. And no unsolvable problems have been encountered yet. Challenges: 1) The paper box shifted during the opening Solved with the plastic walls that you can lean against 2) Heat pad, stuck to the gripper instead of heat sync. Can be solved by gripper with a pump, but this time solved with the patience of the operator 3) The film on the pad is very thin. Turned out that sub-millimeter arm precision is enough to peel it off with just a regular gripper. 4) The working area has not enough space. You'll only know this by doing real tasks in bulk. This could be solved by an extra pair of long arms, but in this case, solved with the patience of the operator. I think that in the end, we will have 5-10 types of universal tooling and 5-10 types of grippers to solve almost all the problems in such assembly tasks. Learning 2. It's slow. It took 5 times more time, than doing it with human hands. But the good news is there's a lot of room for improvement. We now have specific “time for task” metrics, which we will decrease with iterations. The main reasons for slowness: 1) To rotate the gripper to a steep angle you are forced to control one robot arm with two hands instead of using both arms. We can fix this by just making more room for rotations. 2) Grabbing PCB board with two arms is hard. A slight difference in rotation can break the board, and it's hard to control these angles visually. To solve this, the best way is to use force feedback so you can feel the pressure applied to the item. 3) Accuracy and steadiness is still can be improved We will try a metal version and double the motors to do this. 4) It is physically difficult for the human hands to move with such precision To solve this, we will add a pad for the hands like in surgical robots Learning 3. It's a good business model The "Factory in the cloud" is a good business model for this stage. You send us parts and we send back assembled modules. Currently, it's more convenient than sending a robot to your place, as we can iterate/fix the robot quickly and utilize it 100% of the time. When we polish the set-up over time - we can send robots to your place. So if we can assemble something for you in the USA with Chinese prices by using modern automation - leave a comment below.

Igor Kulakov

37,266 views • 1 year ago

🚨 JUST IN: President Trump CRITICIZES Israel for launching attacks in Lebanon on the SAME DAY the Iran peace deal might be signed "LET'S NOT BLOW IT!" "There should be no more attacks by Israel anywhere in Lebanon, but there should also be no more attacks by any other party, including Hezbollah, against Israel. This could be the beginning of a long and beautiful peace." "This morning’s attack on Beirut should not have happened, particularly on a special day when we are so close to a Peace Deal with Iran. Israel has the right to defend itself against threats, but the attack it was responding to was very small and meaningless, nobody was hurt, injured, or killed, and should not disrupt this important process. We are very close to a Deal that will bring peace to the region, including to Lebanon, and all sides should stand down." No more attacks! Make peace happen!

🚨 JUST IN: President Trump CRITICIZES Israel for launching attacks in Lebanon on the SAME DAY the Iran peace deal might be signed "LET'S NOT BLOW IT!" "There should be no more attacks by Israel anywhere in Lebanon, but there should also be no more attacks by any other party, including Hezbollah, against Israel. This could be the beginning of a long and beautiful peace." "This morning’s attack on Beirut should not have happened, particularly on a special day when we are so close to a Peace Deal with Iran. Israel has the right to defend itself against threats, but the attack it was responding to was very small and meaningless, nobody was hurt, injured, or killed, and should not disrupt this important process. We are very close to a Deal that will bring peace to the region, including to Lebanon, and all sides should stand down." No more attacks! Make peace happen!

Eric Daugherty

94,462 views • 2 months ago